School of Public Health

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The collections in this community comprise faculty research works, as well as graduate theses and dissertations.

Note: Prior to July 1, 2007, the School of Public Health was named the College of Health & Human Performance.

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Subject: search.filters.subject.Adolescents

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Now showing 1 - 10 of 11
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    Strengthening High School Transition and Attendance: Exploring Multi-level Risk and Protective Factors for Chronic Absenteeism Among African American Adolescents
    (2021) Holder, Sharifah; Green, Kerry; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Chronic absenteeism is a growing problem in the United States and is associated with poor educational and health outcomes including high school dropout, criminal justice system involvement, chronic disease, mental health concerns and early death. African American children in low income, urban areas are at elevated risk for chronic absenteeism based on factors at all levels of the social ecological model including mental health concerns, systemic and individual racism, parental, peer, and teacher relationships, school and neighborhood climate. The transition to high school is a critical moment when absenteeism rates increase dramatically. This study used a mixed method approach to better understand chronic absenteeism in urban high school settings. A survey gathered data from a cohort of ninth grade students transitioning into high school and regression analysis was used to identify risk and protective factors that may explain chronic absenteeism (n=216). A total of 30 in-depth qualitative interviews were conducted with five chronically absent and five regularly attending ninth grade students from a predominately Black school. Critical Race Theory was used as an analytic lens for the thematic analysis of the semi-structured interviews. Participants discussed challenges and opportunities that arise when transitioning to high school including finding a friend group, coping with anxiety, planning for the future, navigating a new school environment and maintaining ties to rapidly changing communities. Findings suggest that African American students possess many strengths including skilled navigation of social situations, adaptive coping strategies for emotional distress, creating a team of adults and peers for motivation and support, aspirational planning for future goals, and vocal resistance to oppression that can be further developed or cultivated to support positive attendance behaviors and contend with the impact of systemic racism that can sometimes be disregarded in predominately Black schools. Implications include the increased need for student voice in decision making processes, enhanced curriculum that addresses social emotional learning and gives students agency in determining individualized learning plans, school discipline reform, and community engagement. These findings are critical to transforming dominant narratives about chronic absenteeism in low income, African-American communities and providing feasible recommendations to improve educational and health outcomes.
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    The Role of Cross-cultural Experiences and Ethnic Identity in Transracial Adoptees' Self-esteem
    (2015) Stephenson, Jocylynn Briann; Leslie, Leigh A; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Research into mental health outcomes of minority transracial adoptees has been fueled by debate over white parents' ability to prepare minority children for experiences of individual and institutional racism. However, studies show transracial adoptees do not differ from others in self-esteem, one criterion used to gauge mental health. Among minorities, ethnic identity is correlated with self-esteem, but studies show that transracially adopted adolescents often face ambiguous ethnic identity. Cross-cultural experiences have proven to increase ethnic identity in minorities, but little research has been done on their effect among transracial adoptees. The current study explored whether cross-cultural experiences bolster self-esteem in minority transracial adoptees through mediation of adoptees' ethnic identity. One-hundred-three transracially adopted minority adolescents completed online self-report surveys. Results indicated a significant negative link between cross-cultural experiences and ethnic identity and a moderately significant negative link between cross-cultural experiences and self-esteem in this population. Findings and possible explanations are discussed.
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    "I've Got to Help as Best I Can:" The Experiences of Predominately Low-Income African American Parents and Caregivers Involved with the Mental Health Care System and Their Responses to Adolescents' Depressive Disorder Diagnoses
    (2015) Messina, Lauren A.; Anderson, Elaine A.; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Many mental health disorders are often diagnosed in adolescence, suggesting the well-being of adolescent mental health should be a public health priority. The prevalence of adolescent mental health issues has led researchers to investigate treatment utilization and effectiveness. Findings suggest there is a vast underutilization of care for adolescents and an even greater deficit in family involvement in adolescent mental health care. Yet, existing research neither offers a sound understanding of how parents interpret and understand their child's mental health diagnosis, nor how the parent-child relationship and parental involvement in treatment is experienced. A qualitative approach examined parents' and caregivers' perceptions of their adolescents' mental health disorder and how parents made decisions about their involvement in their adolescent's treatment in a sample of families already engaged with the mental health care system. Semi-structured interviews with 33 predominately low-income African American parents and caregivers who had parented a teenager diagnosed and/or treated for a depressive disorder when the family was the recipient of Medicaid were conducted. The Ecological Risk and Resilience Framework facilitated an understanding of the dynamics shaping parental involvement in adolescent mental health care. Grounded theory was used to analyze the data. Findings suggest parents' involvement in the diagnosis process may be initiated after a build-up of problematic events, often identified from sources outside the family. Parental responses to the teens' diagnoses included feeling relief but also confusion, while advocating for the needs of their teenager. The parent-child relationship post-diagnosis reflected four actions: parents being protective, showing patience and empathy, increasing communication with their teen, and teaching the teen accountability. Parents reported they had agency in making decisions about the teen's treatment. They wanted active involvement and saw their involvement as having mutual benefits for both themselves and their teen. Three encouraging components enhanced parental involvement: positive mental health care provider and parent interactions, the parents' own mental health and exposure to mental health care, and spirituality. The availability of insurance also positively supported more involvement. Care barriers included family or teen resistance and lack of resources. Race/ethnicity shaped the expectations parents had of the mental health care system but did not shape parental involvement in treatment. Strategies for forging greater parental connections with mental health treatment and the role mental health care professionals play in this partnership are discussed.
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    Association of Life Events with Depressive Symptoms among Puerto Rican Youth
    (2014) Jaschek, Graciela; Carter-Pokras, Olivia D.; Epidemiology and Biostatistics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    BACKGROUND: Early onset depressive symptoms have amplifying effects on the course of later depression, and serious personal, social and economic consequences throughout the life course. Little has been published regarding socio-demographic determinants of depression and possible mechanisms for the development of depressive symptoms among Puerto Rican youth. This study aims to examine the extent to which life events are associated with the development of depressive symptoms, and how place of residence, parental support, youth self-esteem and youth coping modify that association. METHODS: Secondary analyses were performed of data from the longitudinal Boricua Youth Study (three annual waves between 2000-2004). The sample consisted of 10-13 year old Puerto Rican youth living in New York and Puerto Rico with no depressive symptoms at wave 1, and complete information on depressive symptoms (DISC Predictive Scale which includes 9 significant predictors of depression)at waves 2 and/or 3. RESULTS: Depressive symptoms increase across waves with an increase in total, negative, or positive life events in general; and social adversity, death, and family environment life events specifically. Youth with low coping consistently had a higher number of depressive symptoms than youth with high coping regardless of number of total, negative or positive life events. Youth support from parents was found to be a significant confounder for all types of life events. Parent coping was a significant confounder for social adversity events. DISCUSSION: This study identifies various kinds of life events as risk factors that contribute to the development of depressive symptoms. Early onset depressive symptoms have amplifying effects on the course of later depression, and serious personal, social and economic consequences throughout the life course. Preventing the development of depressive symptoms at an early age should be a priority if we want to optimize the mental health and well-being of youth so that they can reach their full potential. Our findings could inform the development of a first-stage screening tool for youth at risk of developing depressive symptoms in community settings.
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    Sleep Duration in Adolescent Girls: Correlates and Association with Obesity Risk
    (2013) Moshkovich, Olga; Saksvig, Brit I; Epidemiology and Biostatistics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    The present study aimed to identify demographic, behavioral, and school-related factors associated with week night sleep duration among an ethnically diverse sample of 582 adolescent girls from the Trial of Activity for Adolescent Girls (TAAG) 2. The distribution of sleep duration categories (<7 hours, 7-9 hours, and >9 hours) differed significantly among ethnic groups in bivariate analyses, but not in the final multivariate model. Additionally, sleep duration was negatively associated with distance to school from home, typical time spent on the computer, and school start time. In contrast to previous findings, shortened sleep duration was not associated with increased body mass index (BMI), body fat percentage, or quantity of moderate-to-vigorous physical activity (MVPA). Findings show support for delayed school start times. In addition, future research should examine whether interventions to reduce screen time activities among adolescents is effective in increasing their sleep duration.
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    Longitudinal Effects of Mother-Daughter Relationships on Young Women's Sexual Risk Behaviors
    (2011) Berger, Amanda Tennyson; Hofferth, Sandra; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Among adolescent and young adult women, sexual risk behaviors represent a critical public health concern. This study used Waves I, II, and III of the National Longitudinal Survey of Adolescent Health to compare two theories of maternal influence on daughters' sexual risk behaviors: parenting style versus social learning theory. Associations between maternal parenting style (based on Wave I warmth and control) and mother-daughter communication about sex (based on Wave I comfort and frequency of communication about sex) and adolescent and young women's sexual risk behaviors (Wave II and III inconsistent condom and contraceptive use and multiple partnerships) were examined. Further, this study examined whether these associations were mediated by socioemotional characteristics (sexual self-efficacy and risk-taking behaviors) or by sexual knowledge (sexual health knowledge and perceived barriers to contraception), respectively. Controlling for covariates, results indicated that in adolescence: 1) authoritarian and permissive parenting were associated with an increased risk of inconsistent condom use, though this association was attenuated by socioemotional and sexual knowledge risk characteristics, whereas infrequent, uncomfortable communication about sex was associated with a decreased likelihood of inconsistent use; and 2) authoritarian parenting was associated with an increased risk of inconsistent contraceptive use, also attenuated by the addition of socioemotional and sexual knowledge risk characteristics to analyses. Results further indicated that in adulthood: 3) parenting style was not associated with inconsistent condom or contraceptive use, but may have an indirect effect on inconsistent condom use, and that uncomfortable communication about sex was associated with a decreased likelihood of inconsistent contraceptive use; and 4) parenting style was not associated with lifetime sex partnerships, but authoritarian and neglectful parenting were associated with higher numbers of past year partners. These findings indicate that both parenting style and mother-daughter communication about sex may serve as predictors of girls' sexual risk-taking in adolescence and young adulthood and should be areas of focus when implementing sexual health prevention and intervention programs. In particular, this study provides support for utilizing parenting styles in understanding how mothers influence daughters' sexual risk-taking behaviors, however future research should examine the ways in which other variables mediate and moderate these effects.
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    THE EFFECTS OF LOW-VOLUME/MODERATE-INTENSITY AEROBIC TRAINING ON METABOLIC SYNDROME COMPONENTS IN MORBIDLY OBESE MINORITY ADOLESCENTS
    (2010) Many, Gina Marie; Hagberg, James M.; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Despite the increased prevalence of obesity and associated diseases among pediatric minorities, the intensity-specific effects of aerobic training have not been examined extensively in adolescent minorities. Fifteen morbidly obese, sedentary and insulin-resistant Black and Latino adolescents completed two-months of low-volume/moderate-intensity aerobic exercise training to examine the effects of training on three phenotypes dysregulated in obese and physically inactive states: insulin sensitivity (SI); fibrinolytic potential, as indicated by plasminogen activator inhibitor type 1 (PAI-1) and tissue plasminogen activator (t-PA) antigen levels; and chronic low-grade systemic inflammation, as indicated by C-reactive protein (CRP). In response to training, SI increased ~37% (1.00 ± 0.15 to 1.37 ± 0.26 mU.L^-1min^-1, p<0.05) and t-PA antigen levels increased ~15% (6.34 ± 0.51 to 7.32 ± 0.85 ng/mL, p<0.05). No significant changes in CRP or PAI-1 antigen were observed. Our findings demonstrate that aerobic training improves insulin sensitivity and fibrinolytic potential in morbidly obese minority adolescents.
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    Family Structure and Adolescent Well Being: The Mediating Effects of Family Cohesion and Parental Leadership
    (2010) Messina, Lauren A.; Leslie, Leigh; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Research comparing single-parent households to two-parent households suggests better outcomes for adolescents of two-parent households. Much of this research has narrowly focused on assessing the benefits of family structure. The current study explores the family processes of family cohesion and parental leadership as mediators of child well-being in single and two-parent families. Child well-being is assessed through using adolescent self reports of attachment style. Findings indicate no relationship between the proposed mediators, family structure, and adolescent secure attachment. Family structure did not have an impact on the potential mediating variables so mediation could not be established. The possible meaning of the lack of relationship in this sample is discussed.
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    SOCIO-CULTURAL DETERMINANTS OF PHYSICAL ACTIVITY AMONG AFRICAN AMERICAN AND WHITE FEMALE ADOLESCENTS
    (2009) Scott, Wakina L.; Koblinsky, Sally A.; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Low physical activity is a problem for girls, and particularly African American female adolescents. Low physical activity has been associated with increased risks of cardiovascular disease, hypertension, diabetes, cigarette smoking, premature mortality, and overweight and obesity. Families and communities play an important role in influencing adolescent health; however, few studies have examined how these factors influence adolescent physical activity outcomes. Adopting an ecological theoretical framework, the purpose of this study was to examine the relationship between family factors (maternal control, maternal support, mother-child communication, and family cohesion), a community factor (religiosity, defined as attendance at religious services and religious youth activities) and physical activity among African American and White female adolescents. Wave I data from the National Longitudinal Study of Adolescent Health was analyzed. The sample includes 736 African American and 1,692 White female adolescents in grades seven through 12. Descriptive statistics were computed for all family and community measures. Logit models were used to evaluate family and community influences on female adolescents achieving five or more bouts of moderate to vigorous physical activity per week (MVPA); and whether the relationship between maternal control, maternal support, mother-child communication, family cohesion, religiosity, and MVPA was moderated by race. Maternal control was a significant predictor of MVPA for the total sample and the White female sample, with increased levels of maternal control associated with increased adolescent physical activity. Mother-child communication and religiosity were significantly positively associated with MVPA for African American females only. Maternal support and family cohesion were not found to be significant predictors of adolescent girls' physical activity in any of the models. Race significantly influenced the strength of the relationship between mother-child communication and adolescent MVPA, and between religiosity and adolescent MVPA, with findings revealing a stronger relationship for African American female adolescents than for White female adolescents. Strategies to engage female adolescents in physical activity, particularly African American female adolescents, should focus on increasing mother-child communication and girls' involvement with religious institutions.
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    Environmental influences on physical activity and obesity in African American adolescents-a multilevel perspective
    (2009) Yan, Fang Alice; Beck, Kenneth; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Background: Prevalence of obesity among adolescents is increasing at an alarming rate. Currently, 34% of all 12-19 year olds are either at risk for overweight or are overweight. Without a comprehensive understanding of the myriad of environmental factors that influence physical activity, we cannot effectively curb the rising rates. Methods: The objective of this study is to evaluate the direct and indirect effects of individual, built, and psychosocial environmental factors on the body mass index (BMI) of African American adolescents, and to assess how the relationships may be mediated by physical activity (PA) levels in an urban setting. A cross-sectional sample of 350 Students (grades 9-12) was drawn from two urban magnet high schools in Baltimore City. The outcome measurements cover a broad array of variables, including BMI, walking behavior, and overall PA. The independent variables are measures of three environments and individual socio-demographic status. The hierarchical linear model analysis was employed. In addition, the mediation analysis was conducted to examine the mediating effect of PA levels. Results: The majority of the sample was African American (69%) and female (58%) with 40% at risk of overweight or overweight. After adjustment for individual socio-demographic factors, living in more hazardous neighborhoods was positively associated with moderate-to-vigorous physical activity (MVPA) and walking for transportation but not with BMI. Densities and proximities of destinations were not associated with BMI. Access to school and museums within 0.25 mile, and grocery stores, retail and shopping, post offices and mix of destinations within 0.5 mile and beyond was positively associated with participation in walking. In addition, densities of fast food restaurants, parks and recreation within 1 mile and 1.5 mile were associated with increased walking. Closer proximity to schools and museums increased both student's MVPA level and their walking trips. Green space coverage within 0.25 mile distance was associated with decreased BMI. In addition, the percentage of green space coverage around homes was not associated with physical activity. Physical activity did not mediate either the destination densities and proximity or the greenness on BMI. Conclusion: The findings support the importance of focusing on places rather than the individuals who live in those places. Increasing the diversity of walkable destinations may contribute to adolescents doing more transport-related walking and achieving recommended levels of physical activity. In general, ecologic approaches to obesity prevention need to focus on urban design and food availability.